Provider Demographics
NPI:1831278787
Name:SCHAFFER, JOEY DIANE (QMHW)
Entity type:Individual
Prefix:MRS
First Name:JOEY
Middle Name:DIANE
Last Name:SCHAFFER
Suffix:
Gender:F
Credentials:QMHW
Other - Prefix:MISS
Other - First Name:JOEY
Other - Middle Name:DIANE
Other - Last Name:NICHOLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:QMHW
Mailing Address - Street 1:500 W FOSTER RD
Mailing Address - Street 2:
Mailing Address - City:ORCUTT
Mailing Address - State:CA
Mailing Address - Zip Code:93455-3620
Mailing Address - Country:US
Mailing Address - Phone:805-343-1194
Mailing Address - Fax:805-343-0934
Practice Address - Street 1:500 W FOSTER RD
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93455-3620
Practice Address - Country:US
Practice Address - Phone:805-934-6385
Practice Address - Fax:805-934-6525
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool